Individual
MARK JAMES ZIEBARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHCNS-BC
Contact information
Practice address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
(651) 628-9566
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP2295
MN
363L00000X
Nurse Practitioner
Primary
R0820659
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011796
PREFERRED ONE
MN
01
—
167750
BHP UCARE
—
01
—
208M0Z1
BCBS
MN
01
—
6267250
UBH
MN
01
—
641K1ZI
BCBS
MN
05
—
816750801
—
MN
01
—
8363352
UBH
—
01
—
890001087
RR MEDICARE
—
01
—
990991011796
PREFERRED ONE
MN
01
—
HP25418
HEALTH PARTNERS
MN
Enumeration date
04/07/2006
Last updated
12/30/2013
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